Application

Complete the form below to apply for open positions at Mayworth’s Public House.

Step 1 of 5 - Personal Information

20%

Name*

FirstMiddleLast

Address*

Street AddressAddress Line 2CityStateZIP Code

Phone*

Email*

SSN

Desired Salary

Position Applying for*

Are you a citizen of the United States?*

Yes

No

If no, are you authorized to work in the U.S.?*

Yes

No

Have you ever worked for this company?*

Yes

No

If yes, when?*

Have you ever been convicted of a felony?*

Yes

No

If yes, please explain.*

High School

Name

Address

From

To

Did you graduate?

Yes

No

College / University

Name of College / University

Address

From

To

Did you graduate?

Yes

No

Degree

Other Education

Name of Institution

Address

From

To

Did you graduate?

Yes

No

Degree

Reference 1

*Include full name, relationship, company, phone/email and address.

Reference 2

*Include full name, relationship, company, phone/email and address.

Reference 3

*Include full name, relationship, company, phone/email and address.

Previous Employer #1

*Provide company name, phone, address, supervisor & job title

Additional Details

*Provide starting and ending salary, responsibilities, start and end dates, and reason for leaving.

May we contact the previous employer above for a reference?

Yes

No

Previous Employer #2

*Provide company name, phone, address, supervisor & job title

Additional Details

*Provide starting and ending salary, responsibilities, start and end dates, and reason for leaving.

May we contact the previous employer above for a reference?

Yes

No

Previous Employer #3

*Provide company name, phone, address, supervisor & job title

Additional Details

*Provide starting and ending salary, responsibilities, start and end dates, and reason for leaving.

May we contact the previous employer above for a reference?

Yes

No

Have you previously served in a branch of the military?

Yes

No

If yes, please provide additional details.

*Provide dates served, branch, rank at discharge and type of discharge. Please provide additional details if other than honorable.

eSignature*

By signing above, I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.